Angelina Alba

Individual provider Active NPI Foster Care Agency · Kahului, HI

NPI 1558085183 · NPPES record last updated Sep 27, 2022

Key facts

NPI
1558085183
Entity type
Individual (NPI type 1)
Primary specialty
Foster Care Agency 253J00000X
License
4-22059 (HI)
Practice address
808 Poai PL
Kahului, HI 96732-2646
Phone
(808) 868-1507
Fax
(808) 214-6667
NPI assigned
Sep 27, 2022
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
4-22059HIMDFoster Care Agency

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Foster Care Agency 253J00000X 4-22059 HI Yes

Addresses

Primary practice location

808 Poai PL
Kahului, HI 96732-2646

Mailing address

808 Poai PL
Kahului, HI 96732-2646
Phone (808) 868-1507

Other identifiers

IdentifierTypeStateIssuer
4-220059OtherHICOMTIES OF AMERICA

Other providers in Kahului, HI

All providers in Kahului, HI · Foster Care Agency in Hawaii

Sources for this page

Verify at the official NPI Registry.